squad (and anyone else)! i need some more of your advice...

[lcg]

hi. have chronic osteoarthritis which affects hands, feet, knees and hips, to the point where i am struggling to walk and cannot bend/kneel down and get back up elegantly any more! i used to take co-codamol 30/500s but that changed to butrans 35 patches two weeks ago. initially, this helped and it felt great for a few days, but i now have high levels of pain again and have to resort to topping up with my stash of co-codamol in order to go to work. can i get higher doses of patches and if i do, will these work? if not, where does my treatment plan go from there? am fed up and really quite sad that the patches haven't worked as well as i had hoped and very scared that i am going to become completely crippled by this disorder. mtia x

[Sqad]

What strength of Butrans are you taking?
5.10 or 20 micrograms?

[LoftyLottie]

Hi Icg76. I am in the same boat as you. Have had osteoarthritis to some degree since my early teens and it seems to be everywhere now. I always worried that I would end up in a wheel chair and still may one day. But I am 64 now (well I will be in a couple of weeks) and still getting about.

To be honest, I can't take Codeine but have had various types of prescribed drugs for arthritis over the years and none have been very successful or have caused other problems.

I have been better since I stopped working and got more active. I sat at work all day. I have found that by walking more and using my joints things have actually improved for me. Sometimes this is impossible (I also have arthritis in my spine) and I do have to limit myself sometimes and listen to my body.

A good physio or osteopath can help a lot. I haven't been recently, but a gentle practitioner can help you to keep your posture correct which really does help.

I am now just taking paracetamol and sometimes Ibuprofen if things are really tough but I don't have a drug regime any more.

Quite honestly the arthritis in my feet in the worse of all!

[Wak]

I'm not sure if the following site will help but it certainly makes interesting reading regarding your condition.
http://articles.merco...thritis-patients.aspx
I hope you get some pain relief soon as you are sounding desperate.enough to try anything which may possibly help.

[lcg]

taking butrans 20, squad. lottie - i am a nurse and so very active at work. this just seems to aggravate things - i also cycle to get around and have plenty to do when i am not at work! just don't know what to do anymore x

[bednobs]

have you ever tried morphine?

[LoftyLottie]

It's a really horrible thing isn't it Icg. And so many people affected. I don't think a lot of people realise how disabling it is. If I am honest I am always in pain of some sort and am so used to it I don't realise it. I find mornings are worse. Have you seen a rheumatologist lately.

I would think a nursing job would make things worse for you. It's exercise but not the best sort, especially with bending and lifting. I can't cycle any more because I can't grip handlebars and it hurts my bips. I stick with walking.

I really do sympathise and empathise with you.

[LoftyLottie]

I believe morphine and codeine are the same source bedknobs,

[lcg]

bednobs - they seem to be very reluctant to give me anything! this is due to the fact that i took drugs when i was younger (about 20 years ago) and this gets slapped in my face at each consultation. they also tried to tell me that my depression (which is under good control) is making the pain worse too. i did flip my lid at that point tho and told her she was talking out of her @rse. am willing to try pretty much anything now! x

[LoftyLottie]

With respect Icg76, I suffer from anxiety and depression and it does make the pain worse.

My walks with the dog in the fresh air help with my mental state which also helps my physical state.

[lcg]

lottie...i know it has some bearing on it, but my mood was lowered at the time by the fact that i am constantly in agony and not even getting decent sleep. there were no other factors in my life except for the pain. it's always about the bl00dy pain at the moment! am a mental health nurse, so have much more knowledge and insight than most. the major thing that really gets my goat is that i had to wait 5 months for both pain clinic and rheumatology appointments and that i have to wait a further 3 months for the next check ups. my gp won't touch my meds inbetween as he feels 'they know best' and the historical drugs stuff, even tho he knows i don't do it now!!!! x

[LoftyLottie]

I know Icg. It's a vicious circle isn't it. Depression can make pain worse and pain makes you depressed.

I don't think there is a majic answer - we are all so different. x

Chin up.

[bednobs]

Have you ever tried the expert patient programme, or th echallenging arthritis programme?
Morphine and codiene are both opiates, but you can take stronder doses of morphine, whereas cocodamol has a limit.
Have you thought about carrying on with paracetamol regularly?
can you take nsaids?
what about amytriptyline?

[LoftyLottie]

Bednobs, to be honest taken paracetamol regularly has been far more beneficial to me than any of the arthritic drugs. I always take them at night (as suggested by the doctor) and probably once during the day, but at bad times every four hours.

[bednobs]

paracetamol is a great drug, but so often overlooked in chronic pain - i have no idea why?

[bednobs]

Also meant to say that acupuncutre can help

[Sqad]

Difficult problem as you have discontinued Co-Codamol and replaced it with Butrans which is not doing the trick. As bednobs has hinted, it looks as though you will need a combination, perhaps Butrans and Co-Codamol or even Butrans and Tramadol, however, this would be for your medical advisers.

I would certainly start by increasing the dose of Butran to a 20mcgm patch+ a 5mcgm patch, but unfortunately your GP seems a bit nervous!

[mrs_overall]

Go back to your GP and INSIST on a change of meds. Don't be fobbed off.

[seadogg]

For what its worth Mrs S. has recently had steroid injections which seem to have done the trick for her knees. Acupuncture sorted the pain for me after a climbing accident which shunted the vertebrae. Hope you find an answer to this brutal condition.

[lcg]

don't get me wrong, but acupuncture is jolly nice (for me, only when being administered and for a very short time after) but is not effective. tried meloxicam, pregabalin, ibuprofen, diclofenac, gabapentin and now butrans. how much other stuff is out there? my arthtritis is getting worse quite rapidly (it is aggressive onset)...but surely something will work? x

[Scarlett]

Have you tried amiltryptyline (sp?). I haven't tried mine yet but I was prescribed it at the lowest dose (10mg a day) for chronic pain caused by arthritis. I am avoiding trying it until I have a free day the next day as it is supposed to maybe make you dozy, but you could ask about it?